Immediate Postoperative Care & Pain Management

Foot and Ankle Surgery, first 24-72 hours
Office phone: (352) 562-7590

Follow your surgeon’s specific instructions given preoperatively. Some pain and swelling are expected after surgery. These steps can help keep you comfortable and protect your recovery. 

1. Rest and elevate
● Rest with your foot above heart level as much as possible during the first few days.
● Support your leg with pillows, avoiding prolonged pressure on the heel.
● Limit time with your foot hanging down, which may increase swelling and throbbing.
● Use your boot, surgical shoe, crutches, or walker as directed. Put weight on your foot only as allowed.

 2. Ice behind the knee
● If approved by your surgeon, place a wrapped ice pack behind the knee of the operated leg for 15–20 minutes at a time, every 2–3 hours while awake.
● Keep a thin towel between the ice pack and your skin. Keep your surgical dressing dry.
● Do not sleep with ice in place. Stop if your skin burns, changes color, or becomes unusually numb.
● Do not ice an area with reduced feeling from a nerve block or poor circulation unless your care team specifically approves.

3. Adjust only the outer bandage as directed
● If your surgeon has instructed you to adjust a tight wrap, remove only the top elastic bandage, then reapply it more loosely.
● Leave the sterile gauze, padding, incision covering, and splint in place. Do not remove or alter a cast.
● The outer wrap should feel supportive without squeezing. If you cannot identify the correct layer, call the office.
● Call promptly if pressure or pain continues, or your toes become cold, pale, blue, or increasingly numb.

 4. Take medications as prescribed
● Follow your medication schedule. Do not take extra doses or shorten the time between doses.
● If you received a nerve block, follow the instructions for starting pain medicine before it wears off.
● Check before adding over-the-counter medicines. Some prescription pain medicines already contain acetaminophen (Tylenol).
● Avoid alcohol and driving while taking opioid pain medicine. Do not combine it with sleep medicines or other sedating drugs unless approved.
● Call if pain remains severe despite medication, elevation, and the instructed bandage adjustment.

When to get help
Call your surgical team promptly for worsening or uncontrolled pain, fever of 100.4°F (38°C) or higher, spreading redness, foul drainage, a wet dressing, or bleeding that soaks through the bandage. New calf pain or swelling needs urgent assessment.

Seek emergency care immediately for chest pain, shortness of breath, very slow breathing, difficulty waking, or cold/blue toes with severe pain.